Charting Pediatrics

On behalf of the Charting Pediatrics team, we would like to wish you Happy Holidays and a very Happy New Year! 2019 has been a year of explosive growth for the podcast. We went from averaging 8,000 monthly downloads in January to more than 33,000 monthly downloads last month. Thank you to each one of you for listening and sharing the podcast with your colleagues. Connecting with some of you in person at the 2019 AAP Conference was really a highlight for us. We appreciate you coming by the booth and we love reading the emails and tweets that you send our way. We will be taking the next couple of weeks off from releasing new episodes and will look forward to kicking off our first episode of 2020 on Tuesday, January 7th. Happy Holidays!

In this episode we are fortunate to be talking with Bernard Dreyer, MD from the New York University School of Medicine discussing school and health care provider partnerships that have been successful in addressing effects of childhood poverty.

Dr. Dreyer is past president of the American Academy of Pediatrics (AAP) having served as the 2016 AAP president.

Dr. Dreyer is a general and development-behavioral pediatrician who has spent his professional lifetime serving poor children and families. He is Professor of Pediatrics at NYU where he leads the Division of Developmental-Behavioral Pediatrics and is Director of Pediatrics at Bellevue Hospital; he also works as a hospitalist.

This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana.

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

In this episode we have the pleasure to talking with Adiaha Spinks-Franklin, MD from Texas Children's Hospital about strategies to help sleepless teens.

Dr. Spikes-Franklin is Associate Professor of Pediatrics at Texas Children's Hospital and the Baylor College of Medicine in Houston.

Dr. Spinks-Franklin's research interests are in the areas of the cultural aspect of child development. Her previous research experience included studying the development of children in Senegal, West Africa, and studying the mental health impact of the aftermath of Hurricane Katrina on school-aged African American children in Houston. Other research experiences including exploring the racial identity development of school-aged African American and Latino children in the Houston area who are participating in a reading intervention program. She has also studied healthcare disparities among children with Autism Spectrum Disorders. She is currently studying the effect of Adverse Childhood Experience (ACEs) among children and adolescents with developmental disabilities.

This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana.

Topics Discussed in this Episode:

• Common presentations that primary care providers will see in adolescents with sleep issues.
• The importance of the patient's history in determining the causes of symptoms.
• The various factors, including the homeostatic and circadian drive, in regulating sleep.
• The difference between REM and non-REM sleep and the physiological processes of each.
• How sleep changes from childhood to adolescence.
• Considering both the genetic and environmental components of sleep disorders.
• How social media activity negatively impacts natural sleep rhythms.
• What parents can do to mitigate some of the environmental hindrances such as electronics.
• Maintaining a teen's circadian rhythm by not allowing them to sleep in over weekends.
• Examples of breathing techniques to help calm down hyperactive or anxious kids.
• The benefits of gratitude journaling and general journaling before bed.
• Night sports and adrenaline: encouraging parents to prioritize their children's needs.
• What families' dinner- and bedtime routines reveal about a household.
• Thoughts on medicating sleep disorders and how melatonin should be approached.

Do you have thoughts about this episode or suggestions for a future topic? Write to us, [email protected]

Substance use among adolescents is pervasive and commonly encountered in primary care pediatrics. According to the most recent Monitoring the Future Study published in 2018, opioid misuse among teens and marijuana use remains stable while vaping device use is climbing to record numbers. The general approach to the assessment and treatment of adolescents with substance use disorders is similar in some respects to adults; however, developmental considerations require an approach tailored to the cognitive, social, and legal status of adolescents.

In this episode we discuss the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of substance use and substance use disorder in adolescents with Christian Thurstone, MD.

Dr. Thurstone is the Director of Behavioral and Health Sciences at Denver Health and Professor of Psychiatry at the University of Colorado Denver.

Discussed in this episode:

• HEADSS Screening Tool
• Motivational Interviewing
• Apply for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000) - Office-based treatment for opioid use in patients aged 16 years and above
• How to diffuse tense family situations in the office
  • Show empathy
  • Slow the conversation down
  • Maintain confidentiality
  • Meet with teens and parents separately
  • EPE - Elicit Permission; Provide Advice; Elicit Feedback "What do you think about what I just said?"
• Another good question to ask teens, "What do you already know about....."

Have feedback about today's episode or suggestions for a future topic? Write to us, [email protected]

Each year thousands of babies born neonatal abstinence syndrome and require specialized medical and psycho-social support. In this episode we discuss the care for newborns who have been exposed to substances, specifically how primary care providers can understand the child's needs and support their caregivers. We are joined by Stephen Patrick, MD from the Vanderbilt University School of Medicine and recorded this discussion live from the 2019 American Academy of Pediatrics NCE in New Orleans.

Dr. Patrick is a neonatologist and associate professor of pediatrics and is Director at the Vanderbilt Center for Child Health Policy. You can view Dr. Patrick's 2019 AAP NCE plenary session on this topic here.

You can reach Dr. Patrick on Twitter @stephenwpatrick and Dr. Brumbaugh on Twitter @DBrumbaughMD

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

In this episode we were privileged to sit down with Megan Sandel, MD, at the 2019 American Academy of Pediatrics NCE in New Orleans to discuss the impact of housing on child health.

Dr. Sandel is an associate professor of pediatrics at the Boston University School of Medicine as well as an associate professor of environmental health at the Boston University School of Public Health. She has held both of these positions for the last eight years, but has been working with the university since 2002, first as an assistant professor. She is the former pediatric medical director of Boston Healthcare for the Homeless program and the first medical director of the founding site for medical-legal partnerships, Medical-Legal Partnership-Boston. In addition to publishing articles and serving on committees, she is considered an expert in her field on the topic of housing and child health.

Resources Mentioned in this Episode:

• HowHousingMatters.Org
• The Hunger Vital Sign Screening Tool by Children's HealthWatch
• Evicted by Mike Desmond
• PRAPARE Assessment Tool

This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana.

Do you have thoughts about this episode or suggestions for a future topic? Write to us, [email protected]

In this episode we discuss the diagnosis and management of child abuse in primary care pediatrics. We are pleased to be joined by Andy Sirotnak, MD who recently released his new book at the 2019 AAP NCE, Child Abuse Medical Diagnosis and Management.

Dr. Sirotnak is a Professor and Vice-Chair for Faculty Affairs in the Department of Pediatrics and the Director of the Child Protection Team at Children's Hospital Colorado.

Do you have questions about this episode or suggestions for a future topic? Write to us, [email protected]

The development and deployment of childhood vaccines represents the most important life saving achievement in the last century, but the status of our protection against vaccine-preventable illness is as fragile as ever in the United States. In 2019 we have already seen the most cases of measles since 1992 — over 1200 — this for a disease that was declared eliminated from the U.S. in 2000. Vaccine hesitancy among families has been fueled by an anti-vaccine movement that has steadily organized during the last two decades, represents an existential threat to the health of children and is the subject of today's podcast.

Our guest is a physician-scientist, pediatrician and advocate we admire greatly — Peter Hotez, MD, PhD. In today's episode we are going to talk about his new book, Vaccines Did Not Cause Rachel's Autism: My Journey as a Vaccine Scientist, Pediatrician and Autism Dad.

Dr. Hotez is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine where he is also the Director of the Texas Children's Center for Vaccine Development (CVD) and Texas Children's Hospital Endowed Chair of Tropical Pediatrics. He is also University Professor at Baylor University, and Fellow in Disease and Poverty at the James A Baker III Institute for Public Policy.

Thoughts about this episode or suggestions for a future topic? Write to us, [email protected]

Pediatric patients, ages 13 to 18 years, with severe obesity should have greater access to bariatric surgery, according to a new American Academy of Pediatrics (AAP) policy statement.

For pediatricians, that means seeking out high-quality multidisciplinary centers for patients who meet criteria; providing timely referrals; and facilitating care before and after surgery for adolescents with severe obesity, defined as a BMI ≥35 or ≥120% of the 95th percentile for age and sex, whichever is lower.

The policy statement, and a supporting technical report, were simultaneously published in Pediatrics.

Today's guest is Thomas Inge, MD, discussing the new AAP policy statement on bariatric surgery. Dr. Inge is a Professor of Surgery and Pediatrics at the University of Colorado School of Medicine and Associate Surgeon in Chief, Director of Pediatric Surgery and the Director of the Center for Bariatric Surgery at Children's Hospital Colorado.

This episode of Charting Pediatrics Podcast was recorded live from the 2019 American Academy of Pediatrics NCE in New Orleans.

Do you have questions about this episode or suggestions for a future topic? Write to us, [email protected]

In this episode we talk with Lewis First, MD and Alex Kemper, MD about studies published in the last year that could change the way you practice pediatrics.

Dr. First (@lewis_first) is Professor and Chair of the Department of Pediatrics at the Larner College of Medicine at the University of Vermont and Chief of Pediatrics at the University of Vermont Children's Hospital. He serves as the Editor-in-Chief of Pediatrics, the peer-reviewed medical journal of the American Academy of Pediatrics.

Dr. Alex Kemper (@AlexRKemper) is the Division Chief of Primary Care Pediatrics at Nationwide Children's Hospital and Professor of Pediatrics at The Ohio State University College of Medicine. He serves as the Deputy-Editor-in-Chief of Pediatrics.

Articles Covered that can be found from Pediatrics:

• Vaccines Updates - What can pediatricians do to increase vaccination rates in their practice?
• How to evaluate a febrile infant under 2 months of age
• Issues in Adolescent and Teen Patients — Suicidality and identifying risk
• Cannabis Concentrate and Cannabinoids — Impact on children and adolescents, including vaping
• LGBTQ Patient Care, including bullying issues and impact/outcomes based on state legislation (i.e. Proposition 8 from California)
• Smoking and Vaping - Combustable cigarettes and e-cigarettes
• CRAFFT instrument - Adapted screening for teens with substance abuse disorders
• Firearm Safety and Protection of Children from Firearms - Where pediatric firearm mortality has occurred relative to gun laws in the United States; morbidity and mortality of children in homes with firearms
• Telehealth - Quality of Care, antibiotic prescribing stewardship, patient satisfaction for Telehealth visits
• Electronic vs Print Books in Kids — Parents interact more with their children when they use a traditional print book than an ebook.
• Maintenance of Certification - Importance of improving quality of care

This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana.

Do you have a question about this episode or a suggestion for a future topic? Write to us, [email protected]